Part I General Considerationss
1. Ageing and Longevity
2. End-of-Life Care in Geriatric Population
3. Elderly Abuse and Neglect
Part II Common Diseases in Older Adults
15. Cardiovascular Diseases in the Very Elderly
16. Kidney Diseases in the Elderly
17. Mental Illness in the Oldest-Old
18. Eye Problems in the Oldest Old
19. Dental and Oral Conditions in the Very Elderly
20. Cancer in the Very Elderly and Management
1. Ageing and Longevity
p 3, loss body moisture เนื่องจาก gradual assimilation-กลืนหลาย of innate heat
Greek and Roman – died young at 40 yr
100 ปีที่ผ่านมา life expectancy 5yr 75% male , 73% female
mortal male – relate work , violence , accidental
female – pregnancy , childbirth
ส่วน infection and non-communicable – พอๆกันระหว่าง f, m
เชื่อว่า loss ovarian H (menopause) – increase mortality and morbidity เนื่องจาก – infection and age-related pathologies
Ageing
p 4
p 5
p 6
p 7
2. End-of-Life Care in Geriatric Population
3. Elderly Abuse and Neglect
15. Cardiovascular Diseases in the Very Elderly
16. Kidney Diseases in the Elderly
17. Mental Illness in the Oldest-Old
18. Eye Problems in the Oldest Old
WHO เอาที่ > 65 ปี มี 8% of world population
sight-threatenning disesae พบมากขึ้นหลัง 75 ปี
Uncorrected refractive error , cataract , macular degeneration ,glaucoma , diabetes -> ทำให้เกิด visual impairment and blindness
The Ageing Eye
จาก light -> ผ่าน structure ต่างๆ เช่น tear film -> cornea -> aqueous , lens, vitreous and retina
photoreceptors -> convert electrical ไปยัง visual cortex ทาง optic nerve
Gradual attrition (ค่อยๆออก) of fixed number of corneal endothelial cell เพื่อ maintaing corneal clarity
– เกิด weakening lens zonules ทำให้ loss accommodation or presbyopia
– เกิด compaction of lens fiber -> opacification of cataract
– Wear and Tear of photoreceptors – age-related macular degeneration -> gradual loss of optic nerve’s ganglion cells , ซึ่งถูกเร่งให้เร็วขึ้นจาก high intraocular pressure
การ development field of neurodegeneration ,stem cell and gene therapy -> revesing some change
Impact of Poorly Seeing Ageing Eye
p 159
19. Dental and Oral Conditions in the Very Elderly
20. Cancer in the Very Elderly and Management